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Kin 187 > Chronic conditions strongly associated with physical inactivity > Flashcards

Chronic conditions strongly associated with physical inactivity Flashcards

1
Q

What is the estimate for US adults with hypertension

A

77.9 million US adults >= 20 years of age and more than 1 billion world wide

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2
Q

Primary Hypertension…

What are the causes

A

Essential, Idiopathic

No definitive cause
Genetic
Alcohol
Stress
High fat diet
High salt diet
Physical inactivity
Obesity
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3
Q

What does idiopathic mean

A

We dont know what caused the hypertension

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4
Q

Secondary Hypertension…

What are the causes

A

Develops through the manifestation of other medical problems

Genetic
Renal
Vascular
Endocrine
Over the counter medications
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5
Q

Pathophysiology of hypertension involves

A

High sympathetic nervous system activity

Structural narrowing of small arteries and arterioles

Reduction of capillaries

Arterial stiffness

Increased resistance to blood flow (TPR)

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6
Q

What detects a change in BP

A

Baroreceptors

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7
Q

Baroreceptors send a

A

Afferent signal to CNS

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8
Q

BP =

A

HR x SV x TPR

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9
Q

Cardiac output

A

HR x SV

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10
Q

What constricts to slow down and build resistance

A

Arteries and arterioles

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11
Q

What controls vasoconstriction

A

VSMC

Vascular smooth muscle cells

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12
Q

What are VSMC

A

Vascular smooth muscle cells

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13
Q

What are VSMC’s controlled by

A

Pre/post ganglion sympathetic neurones

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14
Q

What does pre ganglion sympathetic neurons release

What do post ganglion release

A

Acytle co enz

norephedrine

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15
Q

What has the overall control of BP

A

Kidneys

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16
Q

What is the special considerations for exercise and hypertension with those whose BP not controlled

A

Those whose BP not controlled (SBP >= 140 and/or DBP >= 90) should consult their physician prior to initiating an exercise program to determine if an exercise testing is needed

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17
Q

What is the special consideration for exercise and hypertension for individuals with SBP >=160 or DBP >=100 or with target organ disease

A

Must not engage in any exercise

No exercise testing prior to a medical evaluation and adequate BP management

Medically supervised symptom limited exercise test is recommended prior to engaging in an exercise program test

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18
Q

What do Beta Blockers do

A

Adverse effect on thermoregulatory function

Increase the hypoglycemia in certain individuals

Reduce submaximal and maximal exercise capacity primarily in patients without myocardial ischemia

Decreased submax and max HR

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19
Q

What do Antihypertensive medication such as alpha blockers, calcium channel blockers and vasodilators do

A

Sudden excessive reduction in post exercise BP = postexercise hypotension

Termination of the exercise should be gradual and the cool down period should be extended and carefully monitored until BP and HR return to near resting levels

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20
Q

What are beta blockers

What does it cause the heart to do

A

Target beta receptors in heart which stops NE and Ephedrine from binding and exciting the heart

Therefore slows down heart rate

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21
Q

Mechanism of Digoxin

A

Slows HR at atria to ventricle

Inhibition of sodium potassium adenosine triphosphatase

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22
Q

Mechanism of betablockers

A

Slow HR

Antagonists that block the receptor sites for Epi and NE on adrenergic beta receptors of SNS

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23
Q

Mechanism of calcium channel blockers

A

Slow HR

Reduce strength of cardiac muscle contraction

Prevent or reduce the opening of channels, not allowing Ca++ to get into cells

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24
Q

Mechanism of alpha blockers

A

Relax vascular smooth muscle cells, vasodilate

Reduce vascular resistance

Increase blood flow

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25
A lack of calcium causes
Actin to not be exposed Causes weaker contraction
26
What are the effects of exercise on hypertension
Average reduction of 5 to 10 mmHg in resting BP Potential alterations: Alteration in renal function Decrease in plasma norepinephrine Increase in circulating vasodilator substances
27
FITT recommendation for individuals with hypertension and AEROBIC
5-7 days Moderate intensity >= 30 min of continuous Intermittent for 10 min bouts Prolonged activities using large muscles
28
Estimated number of people in US with dyslipidemia What is it
30% of people Major risk factor for atherosclerotic CVD Abnormal amount of lipids in the blood Hyperlipidemias/hypercholesterolemia
29
What is the cause of dyslipidemia
High fat diet Excess alcohol intake Physical inactivity
30
What are the effects of exercise on dyslipidemia
Lower triglycerides - better skeletal muscle uptake Higher HDL-c concentrations - with sustained aerobic exercise Reduction in LDL and total cholesterol levels - weight/fat loss is required Reduced postprandial lipemia
31
What are the special considerations due to drugs for dyslipidemia
Statin drugs (hydroxymethylglutaryl-CoA) reductase inhibitors are very effective for the treatment of dyslipidemia
32
What does statin drugs do
Statin therapy consistently improves survival by preventing myocardial infarction and stroke
33
What side effects of lipid lowering drugs may occur
May experience muscle weakness and soreness - Myalgia May cause direct and severe muscle injury Unusual or persistent muscle soreness when exercising while taking these medications
34
What is myalgia
Muscle weakness and soreness from taking lipid lowering drugs
35
FITT recommendation for individuals with dyslipidemia and AEROBIC
>= 5 days to max caloric expend 40 - 75% 30-60min to promote weight loss 50-60 min daily Prolonged activities using large muscles
36
What is the estimated % of US adults with obesity
68% overweight/ obese 34% obese 6% extremely obese
37
What is the estimated % of US children with obesity
32%
38
What are the causes of obesity
Diet Sedentary lifestyle Genetics Gut bacteria
39
What is the pathophysiology of obesity
Adipose tissue Leptin CNS/hypothalamus
40
FITT recommendation for individuals with obesity and AEROBIC
>= 5 days Moderate 40 - 60% Progress to vigorous >=60% 30 a day 150 a week Increase to 60min a day 250-300 min a week Prolonged activities using large muscles
41
Metabolic syndrome is the name for... It is seen in _____ of the population It increases.... There are differences in...
A group of risk factors that raise your risk for cardiovascular disease, diabetes and stroke 35% (US adult) Increase with age Difference in sex race and ethnicity
42
How many risk factors do you have to be diagnosed with to have metabolic syndrome What risk factors are they
At least 3 Abdominal/central obesity High fasting blood glucose - insulin resistance, prediabetes Dyslipidemia - high serum triglyceride level, low serum HDL cholesterol level High blood pressure Miscroalbuminuria
43
Metabolic syndrome table??
?
44
What are the causes of metabolic syndrome
Aging Genetics Diet* Sedentary lifestyle* Insulin resistance* Disrupted sleep Stress Mood disorders/psychotropic medication use Excessive alcohol use
45
What are the effects of exercising on signs of metabolic syndrome
Weight loss/abdominal fat loss Decrease in serum triglyceride, LDL and VLDL cholesterol levels Increase in serum of HDL level Reduction in blood pressure Lower fasting glucose - improvement of insulin resistance
46
What is the exercise prescription/recommendation to reduce risk factors associated with CVD and DM (FITT-VP)
Frequency: Minimum 3 days/week and most days of the week Intensity: Initial exercise training at moderate intensity (40-60% of VO2R) Progress to more vigorous intensity (>= 60% VO2R) Time: Minimum of 150 min/week, or 30min/day Type: ?
47
What is the exercise prescription/recommendation to reduce body weight/fat (FITT)
Frequency: 5 days/week and most days of the week Intensity: Moderate intensity Time: Minimum of 300min/week or 50-60 min/day Progression of 60-90min/day Type: ?
48
Recent findings show that to reduce overall metabolic syndrome severity...
Both diet control and exercise is required Diet: Hypocaloric diet Low fat and high fiber diet Mediterranean diet Exercise: Aerobic interval training High/vigorous intensity interval training High intensity endurance exercise mixed with resistance training
49
What is the bottom line Prevalence: Prevention: Treatment:
The prevalence of the metabolic syndrome in the US increasing significantly Prevention: Healthy lifestyle - healthy diet and physical activity Treatment: Change lifestyle - lose weight and reduce risk factors from proper diet and exercise
50
Make flashcards on big flow chart?
?
51
If your SBP/DBP is 130/70mmHg, you are classified as _____ according to the new report from American Heart Association
Stage 1 Hypertension
52
Vasodilators have antihypertensive effects by lowering heart rate
False
53
Chronic exercise (through exercise training) decreases plasma norepinephrine levels in individuals with hypertension because it reduces sympathetic nervous system activity
True
54
Higher resistance on blood vessels could be due to constant contractions of vascular smooth muscle cells caused by higher sympathetic outflow
True
55
Exercise has positive effects on dyslipidemia by _____
Decreasing concentrations of LDL particles in bloodstream Increasing HDL concentrations
56
High sympathetic nervous system activity increases vasodilation and total peripheral resistance
False
57
Following CDD4 recommendations for evaluation of physical functioning, at a minimum patients should be able to do these except
20 sit to stand repetitions in 30s
58
If you relate the intensity of physical activity and breathing, moderate activity at 3-6 METs is similar to the breathing which cannot pass the talk test
False
59
Gait speed can be placed into the perspective of requirements for various activities and outcomes
True
60
If your client’s HDL level is 45 mg/dL, his negative risk factor is absent neutral
True
61
If your patient has bilateral edema, it indicates that he/she may have lymphatic blockage
False
62
FITT recommendation for individuals with hypertension and RESISTANCE
2-3 days 60-70% 1 RM Progress to 80% 1 RM Older/novice individuals = 40-50% 1RM 2-4 sets, 8-12 reps Resistance machine/free weights/body weight
63
FITT recommendation for individuals with hypertension and FLEXIBILITY
>= 2-3 days a week Stretch to point of feeling discomfort Hold static stretch for 10-30secs 2-4 reps Static, dynamic and or PNF
64
FITT recommendation for individuals with dyslipidemia and RESISTANCE
2-3 days Moderate 50-70% 1 RM Progress to vigorous 70-85% 1 RM to improve STRENGTH <50% 1 RM to improve MUSCLE ENDURANCE 2-4 sets, 8-12 reps for STRENGTH <= 2 sets, 12-20 reps for MUSCLE ENDURANCE Resistance machine/free weights/body weight
65
FITT recommendation for individuals with dyslipidemia and FLEXIBILITY
>= 2-3 days a week Stretch to point of feeling discomfort Hold static stretch for 10-30secs 2-4 reps Static, dynamic and or PNF
66
FITT recommendation for individuals with obesity and RESISTANCE
2-3 days a week 60-70% 1 RM Increase to enhance strength and muscle mass 2-4 sets of 8-12 reps Resistance machines/free weights
67
FITT recommendation for individuals with obesity and FLEXIBILITY
>= 2-3 days a week Stretch to point of feeling discomfort Hold static stretch for 10-30secs 2-4 reps Static, dynamic and or PNF
68
What is leptin
Hormone released from adipose tissue which controls the amount of food you can eat
69
What ethnicities are seen in men for metabolic syndrome What about females
Hispanic and white Hispanic and African American

Kin 187 (21 decks)

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